Thorac Cardiovasc Surg 2005; 53(4): 240-242
DOI: 10.1055/s-2005-837647
Original Thoracic

© Georg Thieme Verlag KG Stuttgart · New York

Spontaneous Hemopneumothorax: Is Conservative Treatment Enough?

G. Haciibrahimoglu1 , L. Cansever1 , C. I. Kocaturk1 , U. Aydogmus1 , M. A. Bedirhan1
  • 1Yedikule Hospital For Chest Disease And Thoracic Surgery, Department Of Thoracic Surgery, Istanbul, Turkey
Further Information

Publication History

Received January 31, 2005

Publication Date:
22 July 2005 (online)

Abstract

Purpose: Spontaneous hemopneumothorax is a rare disorder, occurring in 1 % to 12 % of patients with spontaneous pneumothorax. The present review was undertaken to emphasize the potential life-threatening condition of spontaneous hemopneumothorax and reassess the benefit of conservative treatment with chest tube drainage. Material and Methods: From 1997 to 2002, 291 cases of spontaneous pneumothorax were treated in our department. Of these, 9 (3.09 %) developed hemopneumothorax (> 400 ml). The clinical features of these patients and the results of conservative and surgical management were retrospectively reviewed. Results: Seven patients were treated conservatively and two required VATS and thoracotomy because of worsening clinical condition. The amount of aspirated blood ranged from 400 to 3700 ml (mean, 1533 ml). Six patients received a homologous blood transfusion. Conclusions: In conclusion, hemopneumothorax is a serious condition complicating spontaneous pneumothorax. Conservative treatment is adequate in most cases and should be performed if bleeding persists for less than 24 hours after chest tube placement.

References

  • 1 Laennec R TH. A Treatise on the Disease of the Chest. Forbes J (transl). London; Underwood 1821: 198-212
  • 2 Rolleston H D. A case of fatal haemopneumothorax of unexplained origin.  Trans Clin Soc London. 1900;  33 90-94
  • 3 Elrod P D, Murphy J D. Spontaneous hemopneumothorax treated by decortication: A case report.  J Thorac Surg. 1948;  17 401-407
  • 4 Ohmori K, Ohata M, Narata M. et al . Twenty-eight cases of spontaneous hemopneumothorax.  J Jpn Assoc Thorac Surg. 1988;  36 1059-1064
  • 5 Abyholm F E, Storen G. Spontaneous haemopneumothorax.  Thorax. 1973;  28 376-378
  • 6 O'Neill S. Spontaneous pneumothorax; etiology, management and complications.  Ir Med J. 1987;  80 306-311
  • 7 Barry J J, Pfitzer J, Peacock M J. Video-assisted thoracoscopy for spontaneous haemopneumothorax.  Anaesth Intensive Care. 1995;  23 354
  • 8 Fry W, Rogers W L, Crenshaw G L, Barton H C. The surgical treatment of spontaneous idiopatic hemopneumothorax; a review of the published experience with a report of thirteen additional cases.  Am Rev Tuberc. 1995;  71 30
  • 9 Tatebe S, Kanazawa H, Yamazaki Y, Aoki E, Sakurai Y. Spontaneous hemopneumothorax.  Ann Thorac Surg. 1996;  62 1011-1015
  • 10 Kurimoto Y, Hatamoto K, Hase M, Narimatsu E, Asai Y. Aberrant artery as a source of bleeding in spontaneous hemopneumothorax (to the editor).  Am J Emerg Med. 2001;  19 326-327
  • 11 Muraguchi T, Tsukioka K, Hirata S. et al . Spontaneous hemopneumothorax with aberrant vessels found to be the source of bleeding report of two cases.  Surgery Today. 1993;  23 1119
  • 12 Tatebe S, Yoshiya K, Yamaguchi A. Video-assisted thoracoscopic surgery for spontaneous hemopneumothorax.  Surg Laparosc Endosc. 1997;  7 113-115
  • 13 Miyazawa M, Fujita T, Misawa R. et al . Thoracoscopic treatment for spontaneous hemopneumotorax.  Surg Endosc. 2002;  16 1106-Epub 2002, May 7

M. D. Gokhan Haciibrahimoglu

Nispetiye cad. Profesorler sitesi C3A blok No:66/8

Etiler 34337

Istanbul

Turkey

Phone: + 902123585181

Fax: + 90 21 23 51 50 35

Email: ghaciibrahim@yahoo.com

    >